Urticaria as a Sign of Viral Hepatitis

Lockshin, Norman A.

doi:10.1001/archderm.1972.01620070042014

Cited by 29 publications

(9 citation statements)

References 10 publications

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“…The cause of the yellow urticaria remains unknown, but is speculated to be a possible result of the increased permeability of the blood vessels in the urticaria and the subsequent accumulation of the excess bilirubin in the blood into the surrounding dermis 3–5 . However, as detection of bilirubin in the tissue section by Gmelin staining was negative similar to the previous report, 3 other mechanisms may be involved.…”

supporting

confidence: 67%

“…However, it has also occurred in association with end‐stage non‐viral alcoholic hepatitis 3 . Among only four case reports in which yellow urticaria associated with hepatitis to date, 2–5 there has been only one case that described the exact type of infectious hepatitis; this was type B 4 . We report here the first case of yellow urticaria occurring in a type‐C hepatitis patient.…”

mentioning

confidence: 99%

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Yellow urticaria associated with hepatitis type‐C liver cirrhosis

Imanishi

Tsuruta

Kobayashi

et al. 2006

The Journal of Dermatology

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supporting

confidence: 67%

mentioning

confidence: 99%

Yellow urticaria associated with hepatitis type‐C liver cirrhosis

Imanishi

Tsuruta

Kobayashi

et al. 2006

The Journal of Dermatology

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“…59,60 The cause is thought to be hyperbilirubinemia and accumulation of the excess bilirubin in the dermis due to increased vascular permeability. 55,[59][60][61][62] This was confirmed by skin biopsy studies with Hall's staining for bilirubin, which revealed focal deposits of olive-green crystals. 62 Finally, bile acids can be elevated in serum of patients with viral hepatitis 63 and were shown to activate cutaneous mast cells.…”

Section: Discussionmentioning

confidence: 88%

“…Lockshin and Hurley suggested that the urticarial lesions are induced by antigens from the inflamed liver. 55 These antigens would form CICs 7,50 and cause degranulation of mast cells via activation of complement and the production of anaphylatoxins. IgG-and C5a-dependent histamine release from mast cells and basophils is relevant in CSU.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity of viral hepatitis and chronic spontaneous urticaria: A systematic review

Kolkhir

Pereverzina

Olisova

et al. 2018

Allergy

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Chronic viral infections including those by hepatitis B (CHB) virus and hepatitis C (CHC) virus have been reported to be comorbidities of chronic spontaneous urticaria (CSU). Here, we performed the first comprehensive review of the peer-reviewed literature (PubMed, Web of Science and Google Scholar) on the prevalence of CHB and CHC in patients with CSU and vice versa. The prevalence of CHB and CHC in CSU does not appear to be increased. Less than 5% and 2% of patients with CSU have markers of CHB and CHC, respectively, according to most of the 32 studies reviewed. Urticarial rash including CSU occurs in ≤3% of patients with CHC as reported by most of 20 studies analysed. Very few patients have been assessed for the effects of antiviral hepatitis treatment on their CSU, and two but not all reportedly showed improvement. Hepatitis B/C infections appear unlikely to be linked to CSU. We suggest that routine screening for these infections in patients with CSU is not relevant or cost-effective and should not be performed unless liver function tests are abnormal, risk factors or symptoms of viral hepatitis are present, or urticarial vasculitis is suspected.

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“…Initially, excess antigen generates soluble antigen–antibody complexes. The immune complexes contain HBsAg, IgG, IgM, and C3, and anaphylatoxins C3a and C5a, which cause urticarial vasculitis [ 141 , 149 ]. This type of rash can be associated with transient hypocomplementemia [ 140 ].…”

Section: Dermatologic Manifestationsmentioning

confidence: 99%

Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections

Songtanin,

Chaisrimaneepan,

Mendóza

et al. 2024

Viruses

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Hepatitis B virus (HBV) infections affect approximately 296 million people around the world, and the prevalence of any past or present HBV infection during the years 2015–2018 was as high as 4.3%. Acute HBV infection often presents with nonspecific symptoms and is usually self-limited, but 5% of patients can have persistent infections leading to chronic HBV infection and the risk of turning into chronic HBV infection is significantly higher in babies with vertical transmission (95%). Patients with chronic HBV infection are usually asymptomatic, but 15 to 40% of chronic HBV carriers develop cirrhosis and/or hepatocellular carcinoma. In addition to liver-related disorders, HBV is also associated with several extrahepatic complications, including glomerulonephritis, cryoglobulinemia, neurologic disorders, psychological manifestations, polyarthritis, and dermatologic disorders. Making the diagnosis of HBV can be challenging since patients with chronic infections can remain symptom-free for decades before developing cirrhosis or hepatocellular carcinoma, and patients with acute HBV infection may have only mild, nonspecific symptoms. Therefore, understanding how this virus causes extrahepatic complications can help clinicians consider this possibility in patients with diverse symptom presentations. The pathophysiology of these extrahepatic disorders likely involves immune-related tissue injury following immune complex formation and inflammatory cascades. In some cases, direct viral infection of extrahepatic tissue may cause a clinical syndrome. Currently, the American Association for the Study of Liver Diseases recommends treatment of chronic HBV infections with interferon therapy and/or nucleos(t)ide analogs, and this treatment has been reported to improve some extrahepatic disorders in some patients with chronic HBV infection. These extrahepatic complications have a significant role in disease outcomes and increase medical costs, morbidity, and mortality. Therefore, understanding the frequency and pathogenesis of these extrahepatic complications provides important information for both specialists and nonspecialists and may help clinicians identify patients at an earlier stage of their infection.

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Urticaria as a Sign of Viral Hepatitis

Cited by 29 publications

References 10 publications

Yellow urticaria associated with hepatitis type‐C liver cirrhosis

Yellow urticaria associated with hepatitis type‐C liver cirrhosis

Comorbidity of viral hepatitis and chronic spontaneous urticaria: A systematic review

Burden, Outcome, and Comorbidities of Extrahepatic Manifestations in Hepatitis B Virus Infections

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